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Telehealth Frequently Asked Questions 

You can find answers to general questions about telehealth below. If you are looking for a specific topic, select one from these options:

 

Services | Providers | Payments & Claims | Medi-Cal Special Programs

What is telehealth?

California law defines telehealth as “a mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and health care provider is at the distant site." – see Business and Professions Code section 2290.5(e).
 
Telehealth includes telemedicine, store and forward, remote patient monitoring devices, telephone calls, facsimile machines (faxes), tweets, and other electronic health care communication between providers and patients. 
 

What types of telehealth services does Medi-Cal cover?

Existing Medi-Cal benefits when appropriately provided via telehealth can be reimbursable subject to the standard authorization review process. See specifics below:

 

 
For more information, please see the Medi-Cal Provider Manual: Telehealth.
 

Does Medi-Cal pay a different rate for services provided through telehealth than it pays for the same service provided in-person?

Medi-Cal pays the same rate for professional medical services provided by telehealth as it pays for in-person services.
 

Who decides whether or not to provide services via telehealth?

The Department of Health Care Services determines which benefits are appropriately provided via telehealth and the provider determines when it is appropriate to use telehealth to deliver health care, subject to consent by the patient.
 

Does the patient need to consent prior to receiving services by telehealth?

Yes. The patient needs to provide either verbal or written consent to the provider initiating the use of telehealth prior to the initial use of telehealth. The provider needs to document consent in the patient’s medical record. 

 What resources are available to providers?

The California Telehealth Resource Center (CTRC) is a federally designated resource center dedicated to helping providers implement and sustain telehealth programs.  Services include: program needs assessment for implementation or expansion, equipment selection, telehealth presenter training; operational workflow; contracting with specialists; billing; and credentialing and staff roles.   In addition, CTRC also produces a Telehealth Program Developer Kit that can be downloaded from the CTRC website. It provides a step-by-step guide to help providers develop a telehealth program.
 
The Center for Connected Health Policy (CCHP) is a federally designated national telehealth resource center on policy.  The CCHP works closely with all telehealth resource centers in the United States and provides technical assistance to state agencies and lawmakers on telehealth policy.  For recent information on telehealth legislation and policy, visit the CCHP website
Other helpful websites are available on the DHCS Telehealth Resources webpage.
 

Who can I call if I have questions about submitting claims?

Questions about claims and billing may be directed to Telephone Service Center (TSC) at 1-800-541-5555 or via email to Medi-CalOutreach@Xerox.com.

 

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Last modified on: 5/20/2016 12:05 PM